Brazil: The biggest yellow fever outbreak in decades, Aug 2017

Since the beginning of 2017 Brazil has experienced the greatest outbreak of jungle yellow fever in decades. The highest incidence of cases occurred during the months of January to April, coinciding with the rainy season of Southeastern Brazil.

According to the World Health Organization (WHO), yellow fever is an acute viral disease transmitted by infected mosquitoes. The virus that produces yellow fever is endemic in tropical areas of Africa and Latin America. Once the virus is contracted and after an incubation period of 3 to 6 days, the disease can develop in two phases. The first one, usually causes fever, muscular pains, mainly intense back pain, headaches, chills, loss of appetite and nausea or vomiting. Most patients get better and symptoms disappear within 3 to 4 days. However, 15% of patients may enter a second, more complicated phase, where high fever returns and different organ systems are affected. Half of the patients entering this phase die within 10 to 14 days. There is no curative treatment for yellow fever, vaccination is the most important and effective preventive measure against the disease.

From January to date, 797 cases of the disease have been confirmed, with 275 deaths. The state of Rio de Janeiro is the region that presented the most recent confirmed cases of morbidity and mortality caused by yellow fever. With the arrival of the cold season in Brazil the incidence of cases was halted given the climatic conditions that do not allow the mosquito to reproduce.

From December 2016 to August 2017, the Ministry of Health has intensified actions in the areas of promotion, health surveillance and patient care, earmarking 19.2 million reals (about 6 million dollars) in extra resources for 522 cities affected by the disease in the States of São Paulo, Minas Gerais, Espírito Santo, Rio de Janeiro and Bahia. It also budgeted 26.3 million reals (about 8 million dollars) to the States São Paulo, Minas Gerais, Espírito Santo, Rio de Janeiro and Bahia, to be used in health surveillance actions.

The Ministry of Health allocated 26.9 million doses of vaccine against yellow fever for 1,050 municipalities at risk in the states of São Paulo, Minas Gerais, Espírito Santo, Rio de Janeiro and Bahia. Likewise, it allocated 13.8 million reals (about 4 million dollars) to 256 municipalities of the mentioned states as an incentive for the vaccination of the population against this disease. These activities were aimed at achieving an immunization coverage in the population greater than 95%.

The Brazilian Red Cross in face of the epidemic

The Brazilian Red Cross has been working in affected areas since the beginning of the health emergency, with more than 400 volunteers from the state and municipal branches present in the States of Sao Paulo (Sao Paulo, Santos, San Vicente, San José, Jacareí And Braganza), Rio de Janeiro (Nueva Friburgo), Minas Gerais (Belo Horizonte) and Ceará (Fortaleza).

To respond to this outbreak, the Brazilian Red Cross requested the International Federation of Red Cross and Red Crescent Societies (IFRC) resources from the Emergency Response Fund (DREF) to provide assistance to 26,100 people (6,525 families) with the aim of reducing the risk of yellow fever transmission through health, water and sanitation activities, hygiene promotion, vector control and psychosocial support. In addition, the Brazilian Red Cross has been implementing an awareness and communication campaign that has reached about 50,000 people in the most affected communities in southeastern Brazil.

Although incidence rates have dropped significantly, a study recently published by the Oswaldo Cruz Institute (IOC / Fiocruz) in association with the Pasteur Institute in France indicates that there is a potential for re-emergence of urban transmission of yellow fever in Brazil. This study recommends strengthening vaccination campaigns and continuing vector control actions. The Brazilian Red Cross, thanks to its network of volunteers throughout the country, is alert to any resurgence of the epidemic and thanks to the actions carried out in the first half of 2017, it has the capacity to act immediately.

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